The Invisible Power of Tchotchkes

One of the joys of being a psychotherapist is the opportunity to weave creativity into the healing process. In my practice, for example, I learned by accident the power of fiddling with small toys.

One day, I found a small charm on the floor in my office. It was a pale yellow, heart-shaped stone, smooth to the touch. I did not know whom it belonged to, so I left it on the coffee table that sits between me and my patients, assuming the owner would reclaim it in his or her next session. In the intervening week, no one did, but many people picked it up and played with it as they talked. I sensed it was helpful to them in their sessions. It seemed to facilitate their ability to open up about sensitive issues. Whimsy in the service of a serious pursuit.

A fiddle toy is any small, hand-held toy that is easily manipulated with little effort or attention. Some provide movement to watch, such as a clear wand or ball with liquid and sparkles that float around inside. Others can be stretched, squeezed, twisted or shaped. Fiddle toys jump into people’s hands before they know it. Fiddling is mildly engaging without being too distracting. That is precisely what makes it helpful in my office.

Psychotherapy is a process of self-searching, of looking within to find personal truths. It is axiomatic that in the course of treatment, patients encounter a range of uncomfortable emotions. Shame, for example, is something that patients commonly wrestle with as they examine their problems. For most, shame is excruciating. It is typical for people to delay or avoid sharing information suffused with shame. The tolerance of shame in psychotherapy is essential but daunting. Shame compels us to shrink back; in therapy, patients recoil in part by avoiding eye contact. This is where fiddle toys work their magic — fiddling is an unwitting coping skill, sublime in its simplicity. Fiddle toys provide a convenient visual focal point for the chagrined narrator.

A patient of mine struggled with debilitating self-hate, which in turn caused her to stay in an abusive relationship. After seeing me for many months, she worked up the courage to disclose what she believed was the unforgivable sin that made her a monster: As a child, she was frequently sexually abused by her older brother. Despite that fact that he was older and bigger, she saw herself as complicit. Consumed with shame, she tearfully admitted that she was afraid I would think less of her or worse, stop seeing her. She conveyed the history of her abuse in painstaking measure. Each session, awash in humiliation, she did not take her eyes off the toy in her hands. Her averted gaze was a protective veil, allowing her to slowly share delicate information.

Over and over in my office, patients formulate their thoughts, retrieve memories and manage their shame by shifting their line of vision to a silly little toy. My fiddle toys are stealth operatives — on the table they look like tchotchkes, but in the hands of someone immersed in psychotherapy, they are confederates. Their charm lies in their invisible power; people tend to be unaware of the ways in which the toys help them. They just look amusing.

For me, the lesson of fiddle toys was unexpected. I had always thought the serious conversations in psychotherapy would involve a patient’s undivided attention. But now I understand — sometimes the opposite is true.

Cindy Solin is a psychotherapist in Longmeadow, Mass.

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Couch features essays by psychotherapists, patients and others about the experience of therapy — psychoanalysis, cognitive behavioral therapy, group therapy, marriage therapy, hypnotherapy or any other kind of curative talk between people behind closed doors. To contact the editors of Couch, send an email to opinionator@nytimes.com. Please include “Couch” in the subject field.